Men with hidden lives at risk of HIV: Test a diverse range of patients for HIV


Latest NSW data shows the lowest annual number of HIV infections in 2018 since records began. However, a small cluster of HIV infections has been observed among patients not typically seen as being at risk of HIV. These recent infections show a need for health professionals to increase HIV testing among heterosexual men who have sex with men and men having sex overseas.

Heterosexual men with hidden lives may be at risk of HIV. These men may be in heterosexual and seemingly monogamous relationships, have children and come from a range of cultural/socio-economic backgrounds. For these heterosexually identifying men, having sex with men may be an activity which is private and separate from their public lives. They may be unaware that they are at risk of HIV nor feel comfortable discussing their risk behaviours. Even if they recognise the risk, they may not feel confident asking for a HIV test. To learn more, listen to the recent RACGP webinar about HIV prevention, testing and linkage to care for these men.

Some HIV infections are acquired by men who have sex overseas, in countries where HIV prevalence is high among the general population or in certain groups e.g. sex workers, men who have sex with men and people who inject drugs. These men could be born overseas or be Australian-born men travelling overseas.

It is important that patients are tested and diagnosed in the shortest time period possible after infection to allow early treatment initiation. Late diagnosis can lead to HIV-related illness otherwise prevented by early and effective treatment. People with undiagnosed infection can also unknowingly pass HIV on to other sexual partners.

Who to test

NSW Health encourages health professionals to test a diverse range of patients at risk of HIV, including people who:

  • ask for a HIV test, regardless of their risk profile
  • are men who have sex with other men (includes men identifying as heterosexual, gay or bi-sexual)
  • have had sex when traveling in a country with high HIV prevalence
  • have had sex with someone from country with high HIV prevalence
  • come from a country with high HIV prevalence
  • anyone diagnosed with another sexually transmitted infection.

The National HIV Testing Portal contains a full list of ‘at risk’ patient groups and clinical indicators for HIV testing.

DBS is a finger prick test for HIV and hepatitis C that may suit some patients and can be ordered online by eligible people. The test is free, easy and confidential and may be attractive for people wanting online test ordering and delivery to a mailing address of their choice.

During HIV Testing Week (01 – 07 June), NSW Health encourages health professionals to avoid assumptions about a patient’s risk, ask relevant questions about sexual practices and offer testing to a diverse range of patients.

Resources to help you test

NSW Health provides resources and support to make HIV testing easier than ever.

Remember, the NSW HIV Support Program and NSW Sexual Health Infolink are there to support GP’s and patients when a diagnosis is made.

Test a diverse range of patients for HIV


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